Test Drive The Fitness Business Blueprint for $1

Written on December 6, 2011 at 5:49 am, by Eric Cressey

Today, Pat Rigsby, Mike Robertson, and I are excited to announce an early holiday gift to people who want to build successful fitness businesses in 2012.

We aren’t just offering you $100 off our best selling product, The Fitness Business Blueprint; we’re also giving you the opportunity to test-drive it for a full 30 days for just $1!

You can pick up your copy or learn more HERE.

We’re very proud of just how comprehensive this resource is.  It doesn’t just cover sales and marketing, but also areas other products along these lines have missed:  staff training, assessment/intake, program design, and personal development (among others).

I should mention that your net payout is actually even lower than you might think, as this is an investment that can be written off on your tax return as a business expense – because it will directly assist you in increasing your income.

The $1 Trial ends on Thursday at midnight, so don’t delay.  Head here for details.

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Experience Doesn’t Come Easily When It Comes to Strength and Conditioning Programs

Written on October 19, 2011 at 8:00 am, by Eric Cressey

As I sat down to write this blog, I recalled a quote I heard some time ago, but only with a quick Google search did I discover that it came from Pete Seeger:

“Do you know the difference between education and experience? Education is when you read the fine print; experience is what you get when you don’t.”

Seeger might be in his 90s and done singing, this quote definitely still resounds – and will continue to do so – in the field of strength and conditioning, even if that wasn’t his intention.

I think one of the reasons it gets us thinking so much is that there really isn’t a lot of fine print to read; the strength and conditioning field is still in its infancy, especially since there was very little research in this area before the 1980s.  And, just when we think we learn something and publish it in the textbook, we discover that it’s completely false (the lactic acid debacle was a great example).   Moreover, we’re dealing with constantly changing demographics; as examples, obesity is rising dramatically, and early youth sports specialization is destroying kids’ bodies and fundamentally changing the way that they develop (examples here and here).

So, it’s hard to learn how to do things the right way (or at least head in that direction) when the information wasn’t available – and the population to which it applies is constantly changing.  It’s like trying to change the tire on a moving car – and doing so without having instructions on how to use the jack in the first place.

Moreover, even when the information is out there, we appreciate that no two people respond to the same stimulus in the same way – and my experiences with baseball players with elbow pain serves as a great example.  I’ve seen dozens of post Tommy John surgery athletes in my career.  Some start throwing before the three-month mark, and others aren’t throwing until six months post-op.  Everyone heals differently – and even once they get back to throwing, every guy is unique.  Some have more shoulder stiffness than elbow stiffness after the long layoff, where it might be vice versa for other guys.  Additionally, many post ulnar nerve transposition pitchers have a lot of elbow stiffness when they return to throwing at 6-12 weeks post-op, while others have absolutely zero complications with their return-to-throwing progression.

If the game is changing, and we never really knew what the game was in the first place – and each person is unique, what do we do?

The only thing we can do is draw on personal experience and the lessons that it’s provided to us.

To that end, if you’re an up-and-comer in the field, you have to look at continuing education as a multi-pronged approach.  You’ve got to read the textbooks and stay on top of the most up-to-date research, but you also have to be “in the trenches” to test-drive concepts and see how they work.

If you’re not in the industry – but want to make sure that you’re getting the best possible strength and conditioning programs – you need to seek out expert advice from someone who has “been there, done that.”  Honestly would you want to be on the table for a surgeon’s first surgery? I know I wouldn’t.

A final option, at the very least, is to educate yourself fully on how to write your own workout routines. That’s one reason why I created two free webinars for you: The #1 Reason You Are Not Making Progress and How to Create a Real Strength and Conditioning Program.

You can check them both out HERE at absolutely no charge.  I’d just ask that you help spread the word with a Facebook “like” or comment or “Tweet” if you enjoyed what you saw.

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Why You’re Not Making Progress in Your Strength and Conditioning Program – and What to Do About It (Free Webinars from EC)

Written on October 17, 2011 at 9:03 pm, by Eric Cressey

I’m proud to announce that I’m officially part of the 21st century, as I figured out how to make webinars!  To celebrate this momentous achievement (for me, at least), I’ve got two free ones for you today:

1. The #1 Reason You’re Not Getting Better

2. How to Create a Real Strength and Conditioning Program

Click HERE to access these webinars – and if you like what you see, I’d really appreciate it if you could spread the word with “Likes” on Facebook and “Tweets” on Twitter.  I’d love for this educational approach to become a mainstay for EricCressey.com moving forward, so it’d be great to hear your thoughts on it and receive some support of it if you think it’s something we should do more of moving forward!

Again, here’s the link to get you started with the first webinar: The #1 Reason You’re Not Getting Better.

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

Alex Maroko’s Readers: How to Create a Real Strength and Conditioning Program

Written on October 20, 2010 at 5:01 am, by Eric Cressey

Because Alex Maroko is a good buddy of mine, I decided to make this webinar available to you at absolutely no cost. If you want to learn about the thought process behind each strength and conditioning program I write – for athletes that range from baseball players, to basketball stars, to professional boxers, to Olympic bobsledders – then look no further.

If You Read Alex’s Daily Emails, Use His Special Show and Go Half-Off Discount Link Below Today for Big Savings!

Click Here to Learn More About Show and Go: High Performance Training to Look, Feel, and Move Better

Developmental Systems – The X & O Factors for Training Young Athletes

Written on May 3, 2010 at 3:25 am, by Eric Cressey

Today’s guest blog comes from Brian Grasso.

The Youth Fitness and Sports Training explosion has happened.

More than $4 billion are pumped into the niches of personalized training and coaching for young people every year in the United States alone (Wall Street Journal, November 2004) and roughly 1 million kids and teens hired a Personal Trainer in 2006 (msnbc.com).

Given those stats and the enormity of both the problems (youth obesity and sports-related injuries) as well as the market size (see above) you’d think that we, as a profession, would have a relatively good working knowledge of how young people need to be trained and guided through a physical education process.

Unfortunately, this is as far from the truth as it gets.

I won’t bloviate or preach.

I won’t reveal my thoughts regarding how ineffectual we choose to be when working with this demographic.

And I certainly won’t use any sardonic overtones about the role of responsibility we should employ when opting to work with such a sensitive and cherished client base.

I will simply appeal to your sense of logic and intelligence.

For the purposes of this article, let me say this:

“Kids” is a term I will use to encompass everyone who inhabits the ages of 6 – 18.

Athletes and Non-Athletes alike.

Miniature superstars, bench-warmers and the overweight, will all be lumped under the same umbrella.

And simply stated, I do this because the development parameters of physical stimulus needed for ALL “kids” is the same – at very least in the beginning phases of training spectrum.

Training stimulus with this demographic is guided, primarily, by physiology.

You train to the organism, not the apparent needs of the young athlete or any potential concerns – for example, increasing the speed of an 8 year old running back or arm strength of a 10 year old pitcher would amount to “apparent needs” of a young athlete.  Attacking measures of calorie restriction and “fat loss” protocol would be examples of “potential concerns.”

Instead, your focus must be on the organism itself.

What a young organism needs to experience in the way of physical stimulus can largely be deduced by chronological age.  Certainly biological age (relative body maturation), emotional age (psychological maturation) and even personality (temperament) can all be factored into the equation, but I have found in my 13-year career that chronological age determents can be successfully applied in 90% of the cases.  The remaining 10% can be accounted for through proper coaching and identification.

Having said all that, the following is a brief rundown of the physical needs of ‘kids’ based on chronological age:

6 – 9 Years Old:

• Guided Discovery – implying that Coaches and Trainers must create games and exercises that involve a variety of movement and guidelines in terms of execution, but allow the ‘kids’ to explore on their own.  This phase is terribly critical for establishing “Athletic Intelligence” and sets the seeds for increased complexity of training in the future

• Outcome-Based Coaching – Coaches and Trainers must restrict their commentary and praise to that of “outcome” oriented verbiage.  For example, when asking a 7 year old to pick up a medicine ball and throw it forward using a chest-pass motion, provide praise on that and that alone with respect to successful execution.  Comments pertaining to form are not required and can impede the natural development of “kids” with respect to establishing “Athletic Intelligence.”

10 – 13 Years Old:

• Learning Exploration – Not dissimilar to Guided Discovery, “kids” must still be encouraged to discover what proper execution feels like on their own.  However, as emotional maturation increases (and while neural plasticity or adaptability is still high) it is also critical to start teaching the essence of primal patterns.  Educating “kids” on how to produce and resist force, create angles or accelerate/decelerate becomes an increasingly important part of the training process.

This is a rough overview.  I admit it.

But learning exactly how to work with “kids” in a training environment is a process of education unto itself.

Just know this for starters:

It’s not about Sets & Reps – it’s about instructing technique through a developmental process.

There’s more, MUCH more I need to cover… And fortunately will be able to.

Next month I’ll be back with another installment.

Until then,  re-read the above.

The “kids” are worth our best effort.

Brian Grasso has trained more than 15,000 young athletes worldwide over the past decade.  He is the Founder and CEO of the International Youth Conditioning Association – the only youth-based certification organization in the entire industry.  For more information, visit www.IYCA.org

Related Posts

The Truth About Kids and Resistance Training
Developing Young Pitchers the Safe Way
Preventing Injuries in Young Athletes

Training Males and Females: Similar, but Different

Written on August 11, 2009 at 8:23 pm, by Eric Cressey

Males and Females: Similar, but Different

During my weekly Pubmed scan, I came across this study the other day:

The Core and Hip in Soccer Athletes Compared by Gender

It seemed like a good fit for this week’s newsletter for a few reasons.

First, we always hear that men and women should train exactly the same.  While there are certainly a lot of similarities between how I personally approach the training of men and women, as I noted in a previous newsletter, there are also a lot of important considerations specific to females.  This study highlights on such consideration: increased hip internal rotation as compared with their male counterparts.

Ask anyone who has ever trained male soccer or hockey players or powerlifters, and if they know anything about assessment, they’ll tell you that a hip internal rotation deficit (HIRD) is a huge problem.  It can lead to knee, hip, or lower back pain and have a markedly negative impact on movement.  Improving length of the hip external rotators – with flexibility drills like the knee-to-knee stretch – is of paramount importance.

Well, those exact same drills would actually increase the typical female’s injury risk.  Excessive hip internal rotation and knee valgus are just a few of the many reasons (also including the hip abductor and core control weaknesses outlined in this study) that most females have more anterior cruciate ligament injuries than males.

The lesson could end there – but it won’t. Why?

I had a female distance runner in for an evaluation on Saturday, and she had very poor hip internal rotation.  A flexibility drill that would be inappropriate for the female “masses” is a great fit for her.  Cases like this make it very clear that it’s important to assess and not just assume.

This is why I’m so excited about the impending release of our new product, which outlines a series of self-assessments and corrective exercises one can use to pinpoint these issues and address them in a targeted fashion.  Keep an eye out for an announcement on its release in the weeks to come.

Feedback on Maximum Strength

“This program took me to the next level of performance with my lifting. After using a variety of programs focusing on fat-loss and hypertrophy and having limited results from them it was great to see such solid increases in strength and physique changes from the program.  In addition, the program focus on dynamic flexibility and foam rolling has resulted in an injury free training cycle and major flexibility and posture improvements.  I would highly recommend this program and book to anyone wanting to make real progress with strength, performance and body composition.”

Dan Hibbert – Calgary, Alberta

Increased body weight by 14 pounds, broad jump by seven inches, box squat by 80 pounds, bench press by 30 pounds, deadlift by 70 pounds, and 3-rep max chin-up by 27.5 pounds.

Check out Maximum Strength for yourself!

New Blog Content

Random Friday Thoughts

Shoulder Range-of-Motion Norms

Stuff You Should Read

Tips for a Bigger Bench

Have a great week!

EC

Building Vibrant Health: Part 4

Written on August 11, 2009 at 6:55 am, by Eric Cressey

Today is the fourth part of a guest blog series from Eric Talmant.  In case you missed them, check out Part 1, Part 2, and Part 3.

Building Vibrant Health: Part 4

By: Eric Talmant

There are several options for getting started with Bill Wolcott’s Metabolic Typing®.  The first option, what I would refer to as the “Entry Level” option, is to buy The Metabolic Typing® Diet. This involves taking the self-test, which allows the reader to identify his or her general Metabolic Type® category and follow the appropriate Metabolic Type® dietary recommendations. It also provides additional self-tests to further customize the diet.

The advantage to this option is that it involves a minor financial commitment, and it is certainly much better for you in terms of following a diet plan rather than just arbitrarily eating ‘healthy foods’.  I feel so strongly about this that I believe there really is no reason every single person should not know their general Metabolic Type®.  Once you know your general type, it is very much like turning on a flashlight in a dark room.  Since you know what foods you should generally be eating to push body chemistry in the proper direction, you can actually begin to build health.  The very first thing you will notice is improvement in energy levels; followed shortly by the disappearance of food cravings. For a cost of probably $10 or less for a used copy, it just does not make any sense to me NOT to at least take this basic first step.

The second option is to take the Advanced Metabolic Typing® Test from a certified Metabolic Typing® advisor.  You are certainly welcome to take the test from me, or if you feel more comfortable working with a local Metabolic Typing® advisor, then visit this link for a list of advisors in your area.

The Metabolic Typing® Test offered by Certified Metabolic Typing® Advisors is the most specific test you can take to determine your Metabolic Type®.

The HealthExcel System of Metabolic Typing® analyzes 11 Fundamental Homeostatic Controls (FHC) to determine and define one’s Metabolic Type®. These FHCs are:

1. Autonomic Nervous System (NeuroEndocrine-Sympathetic/Balanced/Parasympathetic)
2. CarboOxidative (Fast/Slow/Mixed Oxidation)
3. Steroidal Hormone Balance (Pregnenolone/DHEA/Androgens/Estrogens/Progesterone/Cortisol)
4. Neurotransmitter Balance (Excitatory/Inhibitory)
5. LipoOxidative (Anabolic/Catabolic)
6. Electrolyte (Stress/Insufficiency)
7. Acid/Alkaline (6 different kinds of imbalances)
8. Endocrine Type
9. Blood Type
10. Constitutional Type
11. Prostaglandin Balance

The Metabolic Typing® Test is the most accurate method of determining Metabolic Types® available in the world today. It is the result of an evolutionary process spanning nearly 30 years, and is based on the input of thousands of practitioners around the world and hundreds of thousands of users.

This online test contains a series of questions about physical traits, diet-related traits, and psychological traits that will identify your dominance and sub-dominance, as well as your endocrine type. There are 9 possible Metabolic Type® combinations involving the pairing of the Autonomic and Oxidative systems. Within each type, one Fundamental Homeostatic Control will be dominant and dictates how nutrients behave in your body.

Knowing your dominance and sub-dominance will guide you in choosing the best foods for your type. The endocrine system plays a role in shaping external physical features and therefore should be considered as you select the best foods for you from the approved food list. Consulting with your Certified Metabolic Typing® Advisor will help you fine-tune your meals for optimal health.

(Example of Part of one Metabolic Type’s® Food List that you would get with the Advanced Test)

If you do not have access to a computer, the test can be mailed to you and returned to your advisor for data entry.

Services with the Metabolic Typing® Test often include:

• The most specific, up-to-date color coded diet plan that Metabolic Typing® has for each type, that clearly shows which foods are ideal, neutral, least desirable, and to be avoided for your particular Metabolic Type®,
• 40 additional documents covering lifestyle recommendations,
• Individual supplement recommendations,
• The article “Using Your Diet Plan”,
• Many more documents on how to integrate the Metabolic Typing® lifestyle into your own,
• Sample menus for your type

These resources are extremely helpful in putting you on the right path to a Metabolic Typing® lifestyle. Consultation sessions are also available with the Metabolic Typing® Program, so contact you advisor to find out their rates.  In my practice, I have found that it is not uncommon for someone to take the test and put all of the pieces together for a relatively inexpensive initial investment (on my site this whole package is only $50).  However, when it comes to fine tuning one’s diet and supplements, a Metabolic Typing® advisor sometimes can make all of the difference.  Try the program out for yourself at first and see how comfortable you are with the whole thing. Then, decide whether working with an advisor would be right for you.

Finally, if you would like to really get serious about building and maintaining vibrant health, then most Metabolic Typing ® advisors offer what can be referred to as a “Comprehensive” Metabolic Typing® program.  Comprised of the Metabolic Typing^® Program, in addition to the Signet MRT food sensitivity blood test, the BioHealth 205 saliva functional adrenal stress profile, the BioHealth 101 urine metabolic assessment profile, a Hair Tissue Mineral Analysis from Trace Elements, Inc. and if necessary Neurotransmitter testing for the brain.   This program analyzes all 11 Fundamental Homeostatic Controls and makes appropriate the Metabolic Type^® diet, Metabolic Type^® supplementation and detoxification, exercise, and lifestyle recommendations.

The Comprehensive Metabolic Typing^® Program is designed as a complete lifestyle and advanced health-building program. It is intended as an “optimum health-building program” to help your body rebuild and regain its health, if you’ve lost it, or maximize your potential and keep your good health, if you already have it.

The program typically includes the following components:

• Metabolic Typing^® Test
• Signet MRT food sensitivity blood test
• BioHealth 205 saliva functional adrenal stress profile
• BioHealth 101 urine metabolic assessment profile
• Hair Tissue Mineral Analysis from Trace Elements, Inc.
• All lab fees for the MRT, 205, 101, and HTMA
• Neurotransmitter testing for the brain (if necessary)
• Analysis and interpretation of all test results
• Customized food list
• 2 months of email and telephonic MTA support

This is absolutely the most individualized and advanced program for building health that caters to your unique biochemistry that you will find anywhere.

Now that you all have a basic understanding of the three main options for getting started in the Metabolic Typing® lifestyle, I encourage you to go out and do some more research on your own and perhaps contact a local advisor.  Begin by asking questions about their services. Then, describe to them where you currently are with your health and diet including your level of commitment.  Your advisor will be able to recommend the best options for you.

In Part 5, I will discuss some of the tests mentioned in the Comprehensive Metabolic Typing® program, describe what each one “does”, and discuss why they are important pieces in the puzzle of building and maintaining vibrant health.

About the Author

Eric Talmant is a top lightweight powerlifter and has a “passion for all things nutrition.” A 1996 graduate of the University of Evansville, Eric is a certified Metabolic Typing® advisor. Talmant is certified to offer the Advanced Metabolic Typing® Test as well as order blood work (the Signet MRT Test, U.S. BioTek ELISA IgG allergy test, the High Sensitivity C-Reactive Protein heart health test); as well as the BioHealth Diagnostics Adrenal and Hormone saliva test Profiles.

Eric has competed in the ADFPA, NASA, AAPF, APF, APA, the WPO, and the Raw Unity Meet.  He holds the APF Florida state men’s open equipped squat record of 678 pounds. He has been ranked in the top in the 75K class among all raw lifters in the United States for the past two years and he was a top equipped lifter in the two years before that.

His best equipped lifts are a 683 pound squat, 391 pound bench press, and a 650 pound deadlift in the 75K weight class. His best raw lifts to date are 485 pound squat without knee wraps, 290 pound bench press, and 635 pound deadlift.

He is also the founder and contest director of the Raw Unity Meet, which experienced great success in 2008 and 2009.

Talmant brings a unique skill set and 16 years of nutritional experience to his sponsors BMF Sports, Ultra Life, Inc., Critical Bench, and Titan Support Systems.  He lives in rural Spring Hill, Florida, and can be reached through his web site at www.EricTalmant.com.

Newsletter 161

Written on June 30, 2009 at 7:24 am, by Eric Cressey

I have the normal weekly newsletter posted below, but first a quick announcement: Mike Robertson, Bill Hartman, and I just filmed a new DVD set!  Those of you who have enjoyed all of our products individually can now see what happens when the three of us collaborate.  For more information, check out today’s blog post: A Sneak Peak at the New Project.

The Law of Repetitive Motion: Part 2

In last week’s newsletter, I talked about the first three component of the law of repetitive motion: “I” (injury/insult), “N” (number of repetitions), and “F” (the force of each repetition, expressed as a percentage of maximal strength).

This week, I’ll discuss the “A” and the “R” of this equation.  To begin, amplitude, stated simply, is range of motion.  If we spend our entire lives in limited ranges of motion, we run into problems.

Obviously, this refers to those who sit too often and too long – particularly in poor postures.  I’m a big believer that the best posture is the one that is constantly changing, so I always encourage people to try to get up and move around every 20-30 minutes whenever possible.  If not, I love the idea of simply “shuffling” positions at your computer.  Complement this constant fluctuation of posture with some good training to open up the hips and thoracic spine, and strengthen the upper back and glutes, and you’ll find that being stuck in a job with a small amplitude is a “manageable” problem.

Amplitude can also refer to only doing certain exercises in the gym, particularly those who exercise through a partial range of motion.  It might be people who simply press too often and pull too infrequently, or those who perform a lot of bilateral exercises, but nothing unilateral.  We aren’t just talking about ranges of motion at the joints; we are also talking about the muscles recruited and type of muscle action – concentric, eccentric, isometric – that takes place.

Lastly, working at a specific task for extended periods of time can be a huge issue for some.  Just ask musicians, factory line workers, and even baseball pitchers.  These issues can all impose huge asymmetries that must be addressed both directly (soft tissue work, flexibility training) and indirectly (training the contralateral side, or just exposing the individual to a broader excursion of movement outside this specific task).

So, all that in mind, improving amplitude is all about increasing range of motion in one’s daily life.  Of course, this must be specific range of motion.  You wouldn’t, for instance, want to increase lumbar spine range of motion in most back pain patients, but you would want to optimize hip and thoracic spine mobility.

Rest, the “R” in our equation, is pretty straight-forward: if a tissue is angry, you need to give it time to settle down.  However, just stopping all exercise isn’t always the best bet.

Often, it’s simply a matter of keeping the stress on the tissue below its capacity for loading.  As a great example, a lot of manual therapists with whom I’ve worked actually like people to go out and lightly load tissues that have just been worked in order to teach the tissue to “deform” properly.  For instance, I got a little “Graston Loving” on my biceps a while back, and spent the rest of the day lightly loading the tissues and doing some prolonged stretching sets.  It worked like a charm.

Taking it a step further, though, much of the time, it’s about redistributing stress.  For instance, someone with anterior knee pain may not be able to do a more quad-dominant squat, but instructing that same lifter to sit back into the glutes and hamstrings more can markedly take down the stress on the anterior knee.  Sure, it changes the muscular recruitment of the exercise, but the lifter derives great benefit and keeps the loading on the affected tissues below capacity.  And, in this particular case, he’s strengthening the posterior chain muscles that almost always help to prevent anterior knee pain in the first place.

That wraps up our look at the law of repetitive motion.  It’s certainly not an exhaustive review, but my hope is that it got you thinking just enough to consider how this law applies to the issues you see on a daily basis, as well as those you want to prevent from ever reaching threshold.  For more information, check out the Building the Efficient Athlete DVD Set.

New Blog Content

Random Friday Thoughts
The Who-What-When-Where-Why of Flexibility Training
In the Presence of Greatness

Have a great week!

EC

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Intern Hazing: Installment 1

Written on June 8, 2009 at 9:31 am, by Eric Cressey

If you’re an intern here at Cressey Performance, it’s not enough to just get smarter, become a better coach, and refine your vacuuming prowess.  You have to get diesel, too.

This summer’s crop of interns began to learn that the hard way last Thursday when their introductory challenge, the 16×16 sled relay, was proposed to them.  Lucky for them, we only used three plates (instead of four).  Also lucky for them, they were assisted by Alex Hill, an 17-year-old Cressey Performance athlete (and recent Wayland High School graduate) with about 1.5 years of training experience with us under his belt. As you’ll see, he crushes them.

In watching this video, you’ll realize:

a) Interns do not know how to turn a sled without flipping it over.  Just imagine them trying to parallel park their cars.

b) They went out of order.  And, they stopped early – and then realized that there was more to do. Poor, confused souls.

c) They struggle with double-knotting their shoelaces.

d) They got dominated by a high school athlete (oops…already said that)

e) Several of the intern trips resembled this dude:

f) The sleeve monster attacked two of them prior to this challenge.

g) Roger’s last trip was painful – quite possibly as painful to watch as this.

This Thursday, we’ll be teaching them about the birds and the bees, and then crushing them with something else.  These boys will be diesel by the end of the summer if it’s the last thing we do.

Spondylolysis and Young Athletes

Written on January 17, 2008 at 1:05 pm, by Eric Cressey

Subscriber-Only Q&A: Spondylolysis and Young Athletes

I received this email a few months ago and have been meaning to turn it into a Q&A for quite some time, as spondylolysis is a topic that I think everyone should understand.

Q: I read you spoke at a seminar this sinter on the topic of spondylolysis showing up in young athletes.  I have a 16 year-old son who was diagnosed with this type of stress fracture in his lumbar spine.  He had grown 7 inches over the previous 9 months and our doctor contributed the cause to supporting muscles growth not being able to keep up with the rapid bone growth along with hyperextension of the lower back.  He has recovered quite nicely with rehab being initially rest, isolation and support of the lower back followed by core strengthening when the pain subsided.

Occasionally, he will get very temporary flare up pain.  Could you please give me your opinion on the “do” and “don’t” exercises that could possibly help prevent Spondylolysis from recurring and your thoughts on the subject.  Thanks for your help.

A: First off, here is some background for our readers. Spondylolysis refers to a fracture of the pars interarticularis portion of a vertebra (95% of the time, it’s L5). The pars essentially connects the vertebral body in front with the vertebral joints behind. It’s also known as a “Scotty Dog” fracture because the shape of the pars mirrors that of a dog – and when a fracture is present, it looks like that dog has a collar on (or has its head chopped off, depending on whether you’re a glass-is-half-empty kind of person or not):

Symptoms may come on traumatically (contact injury) or insidiously (overuse, genetic predisposition, or rapid bone growth during puberty). Pain is typically more lateral to the spine than it is centralized.

We have had quite a few athletes come to us with the condition because we work with a ton of athletes in rotational sports, predominantly baseball. In my humble opinion, “spondies” are the new ACL epidemic. Don’t believe me? Check out these numbers from a 2000 study from Soler and Calderon (1):

-8% of elite Spanish athletes affected

-highest prevalence (27%) in those in track & field throws

-17% of rowers, 14% of gymnasts, and 13% of weightlifters had spondylolysis

-L5 most common (84%), followed by L4 (12%).

-Multiple levels of involvement in only 3% of cases

-Bilateral 78% of the time

-Only 50-60% of those diagnosed actually reported low back pain

-Males and females affected equally (although associated spondylolisthesis – or vertebral “slippage” was higher in females)

-Presence of spondylolysis is estimated at 15-63%, with the highest prevalence among weightlifters.

I suspect that these rates are even higher now (eight years later) – and in the U.S., where we have additional rotational and contact sports (as compared to Spain). These numbers – particularly the 40-50% asymptomatic figure – speak directly to the fact that inefficiency is on-par with (if not more important than) the spondylolysis pathology itself. Multiple inefficiencies are to blame for this specific pathology – and many people are just waiting to reach threshold. With that in mind, to be honest, I train all of our athletes under the assumption that they all have a disc herniation or vertebral fracture that we don’t even know about – simply because, according to the research, that’s probably the case! There are more opportunities than ever to participate in organized sports, yet athletes don’t train any more than previously – and DO spend more time sitting.

In fact, about 14 million people – or 3-7% of the general population – have spondylolysis (2), and previous research as shown that asymptomatic disc bulges and herniations may be up in the 80% range (3).

These issues – combined with the fact that 4.4% of six-year-olds present with pars defects – has led to a standard rule in sports medicine where any adolescent athlete with lumbar spine pain for more than three days duration is referred for a bone scan to rule out a fracture. If a pars defect is detected, most doctors will prescribe 12-16 weeks in a back brace: a practice that, while controversial, has yielded favorable healing results.

Risk factors for pars defects have been subdivided into intrinsic and extrinsic. The “*” indicates that these factors are at least partially under our control as strength and conditioning coaches and trainers:

Intrinsic:

-Poor bone mineral density (*)

-Poor lower limb alignment and foot structure (*)

-Faulty muscular recruitment patterns (*)

-Height – Taller (non-modifiable)

-Rapid growth (non-modifiable)

-Body Type – muscle mass, longer spine (* to a degree, some non-modifiable)

-Poor conditioning/muscular fatigue (*)

-Bone pathologies (refer out)

-Menstrual/hormonal irregularities (refer out)

-Genetic predisposition: Inuit > Caucasian > African-American (non-modifiable)

Extrinsic:

-Inappropriate training regimen or surface (*)

-Sporting discipline: Sports demanding repetitive lumbar hyperextension, trunk rotation, and/or axial loading (*short-term, potentially modifiable long-term)

-Footwear (*)

-Cigarette smoking (*)

-Insufficient nutrition – calories, calcium, vitamin D (*)

We can help build bone density with appropriate resistance training and encouraging athletes to consume plenty of calcium and vitamin D. We can train the lower extremity out of alignment problems and faulty recruitment patterns. We can put some meat on athletes to protect them from contact injuries. We can condition athletes so that they don’t fatigue prematurely and break down in their technique. We have some control over the training surface. We can get young athletes out of the 10-pound cinderblock basketball shoes they’re wearing and do more barefoot work. Kids know they shouldn’t be eating the right stuff and not smoking.

So, in spite of all these means of preventing spondylolysis, as is the case with ACL problems, we’ve pursued a reactive – not proactive – model of addressing the issue. Trust me: you can save a kid a lot of pain and frustration if you prevent a fracture instead of bracing it after the fact. So, let’s talk about what are in my opinion the most important things to address in young athletes to protect them from spondylolysis:

1. Train the feet and enhance ankle mobility. Think about what happens to someone who – thanks to modern footwear, muscular weakness, and/or structural predisposition – pronates too much. My good friend John Pallof describes the subtalar joint as a torque converter – meaning that tri-planar motion at/below the joint is converted into tibial and femoral internal rotation. In other words, when you pronate (land/decelerate), adequate stretch of the anti-pronators (particularly gluteus maximus and biceps femoris) is necessary to decelerate that motion. Most people – particularly young athletes – have very little posterior chain strength, and they don’t activate their glutes well. So, this internal rotation isn’t decelerated effectively – and the stress shifts up a bit from the hip to the lumbar spine. Instantly, a foot and ankle issue has become a lumbar spine issue (I could go on and on about how it relates to shoulder and elbow issues in pitchers, too).

2. Improve rotary stability. The more an athlete moves at the lumbar spine, the more likely he is to get injured. Using the baseball example again, there is considerable research demonstrating that young pitchers have higher rotational velocities than professional pitchers – and the younger subjects control their rotation in a less efficient manner. Rotate more, and do so in an inefficient (weak) way – and you’re bound to run into problems at the lumbar spine (and elbow and shoulder, as well).

3. Improve their ability to resist extension. Most of the overuse spondy cases we see are individuals who also have a tendency toward hyperextension. If you can’t fire your glutes in hip extension, you’ll substitute lumbar extension to attempt to get “upright.” Combine that rapid, repeated lumbar extension with rapid, repeated lumbar rotation – and pars defects kick in. For this reason, I love basic movements like prone bridges (and their variations) as well as more advanced progressions such as rollouts on the stability ball and ab wheel (or bar rollouts).

(Note from EC: Jim Smith’s Combat Coreis the best resource I’ve seen with respect to #2 and #3; for those interested in further reading, it provides dozens of exercises for both objectives.)

4. Improve hip mobility. I have covered this above, but hip (and thoracic spine) mobility work hand-in-hand with lumbar spine stability. It’s easier to stabilize a spine that’s above a mobile set of hips.

5. Improve overall strength and power. The more force you generate in your lower and upper body, the less motion you’ll need to utilize at the lumbar spine. Effectively, by making the extremities, hips, and torso stronger, you allow the core to focus on force transfer.

6. Implement appropriate deloading periods. Bone, like muscles and your connective tissues, needs a break to recover here and there. Regardless of how perfect your technique is, you lumbar spine will get chewed up if you swing a baseball bat for five hours per day, seven days a week. Physiological adaptation is all about matching tissue tolerance to tissue loading – and providing adequate recovery time for adaptation to occur.

Now, to get to the question at-hand, return-to-play after a period of bracing is a different story. Believe it or not, we’ve trained guys through their entire 12-16 week bracing protocols. When they’re in the brace, aside from axial loading, there isn’t much that can “get them” – meaning that they’re completely protected from rotation and extension problems.

In fact, the brace does so much of the work for them that you need to make sure they’re seeing a physical therapist at least 1-2 times a week during that protocol to get them out of it to entire that they don’t detrain the deep core stabilizers. The brace also restricts full hip extension and flexion – and thoracic spine ROM, to a degree – so mobility work is very important. If I had to briefly summarize our training programs during bracing protocols, it would be “upper body, single-leg movements, pull-throughs, rotary stability training, mobility work, low-level linear plyos and medicine ball throws.”

And, you know what? That would summarize my recommendations for the short-term when they get out of the brace – because it’s what all athletes need! However, post-spondy athletes are different in several regards:

1. They cannot handle compressive loading the same way, so it must be gradually reintroduced. I have not allowed post-spondy guys to come back to squatting until at least nine months post-bracing – and I only do so if they have no residual symptoms. In terms of axial loading, we always test the waters with a barbell reverse lunge with a front squat grip. If that goes well, we’ll try some front squatting. Most do well with trap bar deadlifts – although I do not bring them back to any Olympic lifts or straight-bar deadlifting in the first-year post-bracing.

2. Sprint mechanics are definitely altered after bracing. I suspect that it has mostly to do with the fact that kids lose hip flexion and extension range of motion and are therefore forced to develop extra hip rotation strategies (usually external rotation) to get range of motion. Others will simply lose hip flexion during the sprinting motion. Typically, cueing knee-drive with these folks and doing some psoas activation work will help to clear things up quickly.

3. We continue with training purely to resist rotation and only start to integrate rotational exercises – including medicine ball throws and cable woodchops – after three months. In most cases, though, the athlete will have returned to play by this point, so if he is involved in a rotational sport, he’ll be encountering plenty of rotation already.

With respect to the athlete in question, if he is still having residual flare-ups (which do happen relatively frequently), he simply isn’t ready for more aggressive loading – presumably because he has some degree of instability in one or more directions. When this is the case, we work around the issue – but check to see if there is a specific deficit that needs to be addressed. It may be as simple as poor breathing patterns or a lack of hip rotation – or it could be something that takes longer to address.

The important thing to remember is that athletes lift weights to get better at sports – not just to get good at lifting weights. Who is to say that a great football player can’t be built without squatting? We have athletes and clients who do not squat – and they still get great results.

All the Best,

EC.

References:

1. Soler T, Calderon C. The prevalence of spondylolysis in the Spanish elite athlete. Am J Sports Med. 2000 Jan-Feb;28(1):57-62.

2. Wineberg, EP. Spondylolysis. http://www.emedicine.com/Radio/topic650.htm

3. Jensen MC, et al. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med.1994 Jul 14;331(2):69-73.